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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Fram ing
<br />lnsu lation/Energ y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar 7 .2o. tl J/.9*rfv)
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif.
<br />FINAL 4-a-/?-//"GA
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />I
<br />OSNF-T BUILDER DELCARATION
<br />I h<.t, rfrm un& FuIy of Fju!, tur I e qslgl fhm 0E Codftlo6 Lrc.d L.w for lh. louori'B rmn (Sd ,01I 5
<br />BBind ed Prcl*io. Cod.) Any Ciry or Com, *htn Equn6 r Fnn lo onnrud. .la, inFove ddnoltn or rq.ir my
<br />srtu.tuc, For ro il! s@.q .ho r.quna lh. .p?li.&l for ruch p.nDit lo 6k . .isn.d trd.'1ar lh.l lE or nE h t 6!.r! l,6Dl
<br />rorh.EtrvtioNoltlE(tntr&r'!LienEdUw{CluD{69,Com.minswnhS6lion?0006fDiviriof,Ioalll.&amdad
<br />ProfdtuB Co&)c lh.r lEor3lE ad@pl rh-r6orr rlEtc! fo.llE ilbs.d dcnFFi ar, vhLlion orsdb. 7011 5 b, Dt
<br />4ptr.n for r pcnn ub1c8 tlE op?li.&l lo ! dvil pdEhy of mt @r. rht fir. lunt.d &llJr lrt@)
<br />-1,
<br />s o$T( of rh. FoFny. or 6, mplorc wilh w.s6 s rh.n eL conFldion, sil d.' ih. $o an0Ernd@ii L,
<br />inradal or olld.d for r.l. tsd.7044. Bsin* ed Prcteios ('od.: Tn. (ontr..loi i l,iccu L2u &6 .ol appl, lo o orM of
<br />lhc Fr',Ety who hrildr or itrqoc UEEtr drl who d6€sch h hims.lfor hd*llor lhDurh ha! or h6 om mploy6,
<br />Folilal rh^ ruci inF!ffi e Di i'rod.d q oGql ii{ * ll hd*6€. r tlillins or itqrFFi i! 5ld $nhin nn. }d
<br />ofcddpldDi, tlE O*G Blitild will l$! t E h,rld' ofFotilB tllr lEor,i dil d h!! or ingu! dE FDFry b. dE FlF or
<br />-1.
<br />N om6 oftlE FlFrr, m.r.lurivcl, codrdtrg sith licqs.d conlo(66 b oMtud rlE prt'jet (S( 7044, Bdn6
<br />d:d PDf6i.n Cod. Ih.(onrrrcror'.l,ic..r.l.as do* 6dl,pplyro mowndofproF<nysho buildrot improv6thaon,
<br />ud sh. off&ls n N.h Fojds *nh r ( onlr&lo(, li.as.d pu6uld ro th. (bnhclois Licce lr$)
<br />I m.rdd urdd sd.n .A &PC forlhll6n
<br />D.t.: Ornc:rloxrltltg)lltElsArla!
<br />DEIIASAIIO!
<br />I h6.by rmm und6 Fdrltt ofpdjurr orc oflfic lollotrins d6l6 nB
<br />-l
<br />t \. rd *ill ni.r.n . cdirEd. olcoMr b Sdf'lEu. r( $dld' 6hFulin. B Fot'd.d for by Scrio. ]?m of lh.
<br />l:tm Co<L. tur de pdfrnrre. of lb "o L. etih tlE Fni i i$.d
<br />I hav. .nd *ill m.inrlin wortcB' .oopdlrxoo 'Bul4.. B r.quftn b, S4l n n ]TUO of th. l$.r coil., for lhc psfolrr@. or
<br />f.l]ni comp.Bdhn insu.scc cmi( a'd Bnicy .trnrba r.
<br />rlcl-
<br />_l cln'lyrhar i.rh.rsLrlmc.of th. work for{hichthFFmit B lsh.ll nor Gnploy lny p.rv'n 'n.nt m ns
<br />e s lo h<om. subjdr ro rh. m*6' cooFu.r trt. laE oa calitumir. dnd os6 lfial il I rrtuld bq.,n rubiEl t. llE
<br />qsnd' empqsd ion FovnioB ofs.<rion l?00 .frh. bbo. (-.d.- I Jull. fonh*nh .lmply {nh rhoF PrulitioN.\l taNlNG rnfurc ro su. r.rt6 conrEudior o164. B unh*6]l lrl ih.ll $bj.rl u dploF l. .rn!ir.l FrlE ud
<br />.n'l arn6 !p ro o* hu rol rhouend d,llr! (t100,000), in aldnir. ro rh. cor iotr dirr36 6 Fori<H for llt
<br />>;
<br />n 1076 ofrh.l,hr(ixjl inrad rd.(
<br />DICBIAI]O!
<br />I hd!b, .rim lrdd Fdly ot Fju,y Or I & lic6t d und.r Fodiot of Ch.Fq 9 {otrlrrBr!€ siti sdbf, ?000) of Divabn I
<br />of rlE Bci6 an PmaGiE Codc d it lidE a in tull foe .d .lld.
<br />F,,.""..,,..,b
<br />k,,,," h- 16 - lo
<br />(0xlrBr(Iroxrlli.DllclcEli(I
<br />I hosr.- imm onild F.!ht oI Frlury lhr rhq. E . onntud.n k dm! .!d., for th. p6r.lrm.. .l rh. $.rk aor q hth lhN tEnn B
<br />nru.d{sd 304?, civ ( )
<br />l-.nd6'! Nm.
<br />-
<br />AIIIJ(AII.II(;I.aAAITO!
<br />I hdibyrlrm u.dd p6rhy oIpejur) on otlhc follori.r d<ldr(ns
<br />tE.oh'on P@n.-A3h€t8 Notificsl ion l_alsd Rqul.l ioB lrnt 40. Pd6)
<br />-R.qu@l
<br />L!!rq of Ndiarrim
<br />/ l.dir rl'a h. r.ddrLr+uh'trrR rr!,J'n!*lEn
<br />_ J.d'rtrl-.iIT..'..'.1i i,lfd,!rr'.{.u!l{ .rh rl,e'l'.ctr'|.{1' r
<br />+:: ::;):-rru;:;'H''i" il :
<br />' P.rn'iremn*(prinr,: ril+ a6rrt5
<br />49lE.bl. lo lhE Foi.<.
<br />io. is coE..1 I rsra lo s'npl, *ith all Cily lnd (ntrnty
<br />rix Ep.sllriv6 o tftn Chy ud cou.ry to ala u!('n tlE
<br />utslt
<br />I
<br />I
<br />L
<br />SLAB Floor
<br />1-t-ln
<br />tt/of $
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